Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 16, Number 4, August 2023, pages 234-239

Clostridioides difficile Infection in COVID-19 Hospitalized Patients: A Nationwide Analysis

Figure 1. Forest plot for the multivariate logistic regression analysis. The analysis has shown that CDI is associated with increased odds of mortality in patients with COVID-19 infection after adjustment for potential confounders. CDI: Clostridioides difficile infection; COVID-19: coronavirus disease 2019.

Figure 2. Forest plot of the multivariate logistic regression analysis for predictors of CDI in patients with COVID-19 infection. It showed that among COVID-19-infected patients, female patients, patients with congestive heart failure, peptic ulcer disease, renal failure, weight loss, diabetes mellitus with complications, cardiac arrhythmias, liver disease, and non-metastatic solid organ tumors have higher odds of development CDI. CDI: Clostridioides difficile infection; COVID-19: coronavirus disease 2019.

**Table 1.** Baseline Demographics and Hospital Outcomes in Individuals With COVID-19 and No CDI Versus Those With Both CDI and COVID-19
Variables	COVID-19 and no CDI (N = 1,045,125)	Both CDI and COVID-19 (N = 4,920)	P-value
Patients in the CDI group were older with higher comorbidity burdens. A comparison of clinical outcomes showed worse outcomes in the CDI group, including higher inpatient mortality and longer length of stay. CDI: Clostridioides difficile infection; COVID-19: coronavirus disease 2019.
Baseline demographic characteristics
Mean age (years)	64.2	69.3	< 0.001
Gender			< 0.001
Male	52.8%	45.8%
Female	47.1%	54.1%
Race			< 0.001
White	52.4%	60.0%
Black	18.4%	19.6%
Hispanic	20.7%	13.6%
Asian or Pacific Islander	3.2%	1.7%
Native American	1.04%	1.46%
Other	4.11%	3.44%
Charlson Comorbidity Index			< 0.001
0	28.1%	13.2%
1	27.8%	17.2%
2	16.2%	17.6%
3	27.2%	51.8%
Hospital outcomes
Died during hospitalization	11.0%	21.6%	< 0.001
Length of stay (days)	7.42	14.1	< 0.001
Total cost of hospitalization (USD)	18,974.51	42,336.23	< 0.001
Septic shock	4.0%	13.4%	< 0.001
Acute liver	0.6%	1.5%	< 0.001
Acute kidney failure	25.2%	41.8%	< 0.001
Acute respiratory failure	51.9%	45.9%	< 0.001
Mechanical ventilation	9.7%	22.4%	< 0.001
Fluid and electrolytes imbalance	48.0%	71.2%	< 0.001
Blood loss	0.3%	1.0%	< 0.001

Table 1. Baseline Demographics and Hospital Outcomes in Individuals With COVID-19 and No CDI Versus Those With Both CDI and COVID-19

Variables

COVID-19 and no CDI (N = 1,045,125)

Both CDI and COVID-19 (N = 4,920)

P-value

Patients in the CDI group were older with higher comorbidity burdens. A comparison of clinical outcomes showed worse outcomes in the CDI group, including higher inpatient mortality and longer length of stay. CDI: Clostridioides difficile infection; COVID-19: coronavirus disease 2019.

Baseline demographic characteristics

Mean age (years)

64.2

69.3

< 0.001

Gender

< 0.001

Male

52.8%

45.8%

Female

47.1%

54.1%

Race

< 0.001

White

52.4%

60.0%

Black

18.4%

19.6%

Hispanic

20.7%

13.6%

Asian or Pacific Islander

3.2%

1.7%

Native American

1.04%

1.46%

Other

4.11%

3.44%

Charlson Comorbidity Index

< 0.001

28.1%

13.2%

27.8%

17.2%

16.2%

17.6%

27.2%

51.8%

Hospital outcomes

Died during hospitalization

11.0%

21.6%

< 0.001

Length of stay (days)

7.42

14.1

< 0.001

Total cost of hospitalization (USD)

18,974.51

42,336.23

< 0.001

Septic shock

4.0%

13.4%

< 0.001

Acute liver

0.6%

1.5%

< 0.001

Acute kidney failure

25.2%

41.8%

< 0.001

Acute respiratory failure

51.9%

45.9%

< 0.001

Mechanical ventilation

9.7%

22.4%

< 0.001

Fluid and electrolytes imbalance

48.0%

71.2%

< 0.001

Blood loss

0.3%

1.0%

< 0.001